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Wednesday, February 11, 2009

Epidemiology of Anorexia Nervosa in Men

This Open Access article looks at the reality of anorexia in men, at least in Finland. There is doubtless some similarity in patterns for the rest of Europe and the US. This is a twin study, so it's going to have some interesting outcomes regarding the genetic links to this disorder.

Bottom line is that anorexia is more common in men than previously believed, and that it looks different in men than it does in women. It may be the difference in manifestation that results in men generally remaining undiagnosed.

Epidemiology of Anorexia Nervosa in Men: A Nationwide Study of Finnish Twins

1 Department of Public Health, University of Helsinki, Helsinki, Finland, 2 New York State Psychiatric Institute, New York, New York, United States of America, 3 Parnassia Bavo Psychiatric Institute, The Hague, The Netherlands, 4 Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, 5 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America, 6 Department of Mental Health, National Public Health Institute, Helsinki, Finland, 7 Obesity Research Unit, Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland

Abstract

Background

To examine the epidemiology of anorexia nervosa in men, we screened Finnish male twins born in 1975–79.

Methods and Findings

Men (N = 2122) from FinnTwin16 birth cohorts were screened for lifetime eating disorders by a questionnaire. The screen positives (N = 18), their male co-twins (N = 10) and those with lifetime minimum BMI≤17.5 (N = 21) were administered the Structured Clinical Interview for DSM-IV anorexia nervosa. The incidence rate of anorexia nervosa for the presumed peak age of risk (10–24y) was 15.7 per 100 000 person-years; its lifetime prevalence was 0.24%. All probands had recovered from eating disorders, but suffered from substantial psychiatric comorbidity, which also manifested in their co-twins. Additionally, male co-twins displayed significant dissatisfaction with body musculature, a male-specific feature of body dysmorphic disorder.

Conclusions

Anorexia nervosa in males in the community is more common, transient and accompanied by more substantial comorbidity than previously thought.

Funding: AR was funded by National Graduate School for Clinical Investigation. Data collection was supported by the National Institute on Alcohol Abuse and Alcoholism (grant AA-12502), the Academy of Finland (Grants 100499 and 201461), the Academy of Finland Centre of Excellence in Complex Disease Genetics. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.